DK Dental Practice

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found this practice was not providing safe care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider has made the required improvements.

During our inspection of this key question, we found concerns related to the safety of the premises, adequacy and availability of emergency equipment and medicines, recruitment, and training, support and development of staff, and the infection prevention and control standards being followed at the practice.

These concerns were in breach of Regulations 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the detailed findings below.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe systems, pathways and transitions is based on the latest evidence we assessed for the Safe key question.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The practice had ineffective processes to identify and manage risks. A sharps risk assessment had been carried out but was not reflective of practice. For example, needle guards were not available for the traditional needles in use. A health and safety risk assessment had not been completed. A health and safety policy was available, which referred to using a practice manual for guidance, but a practice manual was not available. A fire risk assessment had not been carried out following a fire at the practice 11 months ago and recommendations from a local authority fire safety audit had not been completed. The public and employers’ liability insurance policy expired 06/12/2024 and had not been renewed. Following the inspection, we received confirmation that insurance was now in place.

The management of fire safety was ineffective. Records of periodic testing or checks of the smoke alarms, emergency lighting or fire extinguishers were not available, and we did not see documentary evidence of the servicing of fire equipment. In addition, the practice did not conduct fire evacuation drills.

Emergency equipment and medicines were not all available and were not checked in accordance with national guidance. For example, out of date medicines and equipment had not been disposed of, and in date ones were not always available. The temperature checks of the fridge used to store specific medicines were not carried out. The automated external defibrillator (AED) was not switched on and the battery was not inserted ready for use. Spillage kits for bodily fluids were not available.

Staff could access the equipment and medicines in a timely way and knew how to respond to a medical emergency. Staff had completed training in emergency resuscitation and basic life support.

The premises were visibly clean but undergoing restoration and maintenance. The decontamination room had cluttered surfaces, flooring and worktop seals in surgery 1 were not intact, cabinetry was chipped, and there was a small puncture to the dental chair seat.

Hazardous substances were not all clearly labelled or stored safely and did not have appropriate risk assessments or safety data sheets accessible to staff, which was not in line with Control of Substances Hazardous to Health (COSHH) regulations 2002.

We did not see satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. The electrical installation condition report (EICR) dated 09/05/2025 was unsatisfactory and notes 8 potentially dangerous points. We did not see service records for the autoclave, compressor or ultrasonic bath.

Arrangements to ensure the safety of the X-ray equipment were ineffective. The required radiation protection information was not available. There were 3 radiation protection folders, and it was unclear which one was being followed. The local rules were dated 2014 and were not reflective of current practice. There were extensive gaps between the dates of the performance checks for the handheld and portable X-ray equipment in use. There was no ionising radiation warning signage and staff using the handheld X-ray machine did not have personal dosimeters to check for safe levels of radiation exposure. We do not assess compliance with the Ionising Radiation regulations 2017 and the Ionising Radiation (Medical Exposure) regulations 2017 but we do request services to provide evidence that demonstrates their compliance to inform our findings.

The practice did not have systems for appropriate and safe management of medicines. The log in place to monitor and track the use of prescriptions was dated from 14/05/2025. We did not see any logs prior to this. In addition, NHS prescription pads were being used inappropriately.

The practice had a recruitment policy and procedures to help them employ suitable staff, including agency or locum staff. These reflected relevant legislation but were not always being followed. Information relevant to staff employment in their role as required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was not always available. For example, Disclosure and Barring Service (DBS) check seen for 1 staff was not at a suitable level for their role. A full employment history, satisfactory evidence of conduct in previous employment, and information about any physical or mental health conditions relevant to a person ability to perform task, was not seen for any staff. Evidence of Hepatitis B immunity (titre levels) was not available for 1 staff member, and there was no risk assessment in place. Newly appointed staff did not have an appropriate role specific structured induction. Induction did not cover fire safety, policies, medical emergency, infection control, COSHH, confidentiality, safeguarding or radiography and refers to an employee handbook, which we did not see.

Although the practice ensured clinical staff were qualified and registered with the General Dental Council (GDC), we were not assured appropriate professional indemnity cover was in place.

Staff we spoke with could not demonstrate they had the skills, knowledge and experience to carry out their roles.

The practice did not have arrangements to ensure staff training, including continuing professional development (CPD), was up-to-date and reviewed at the required intervals. Not all clinical staff were able to demonstrate that they had undertaken all CPD relevant to their roles as recommended by the General Dental Council. We saw gaps in the following topics: fire safety, safeguarding adults and children, medical emergencies, infection, prevention and control (IPC), learning disability and autism, Legionella, legal and ethical, Mental Capacity Act, Sepsis and complaints handling. Following the inspection, the provider told us they have engaged a compliance company for support with training.

There were ineffective processes to support and develop staff with additional roles and responsibilities. Staff discussed their learning needs, general wellbeing and aims for future professional development during informal discussion, but did not have appraisals or 1 to 1 meetings.

Staff stated they felt respected, supported and valued, and they were proud to work in the practice. They told us that there were sufficient levels of staff on duty at all times. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew how to escalate safeguarding concerns within the practice but were not clear on how to do this externally, as the 2 safeguarding posters to guide them contained different contact details.

The practice had infection control procedures that reflected published guidance, but these were not always being followed.

Staff were aware of infection prevention and control processes but had not received appropriate training and could not demonstrate knowledge of these.

We observed use of personal protective equipment and the decontamination of used dental instruments, which did not wholly align with national guidance. For example, aprons were not in use, the tap on the handwashing sink was not working, a light magnifier for inspecting instruments was broken, the ultrasonic bath’s cleaning solution was not changed regularly and was not temperature checked. In addition, we didn’t see consistent records of the checks of the equipment in use and staff could not demonstrate how to undertake all of the necessary checks. Instruments including X-ray holders, hand scalers and suction tips, kept in clinical areas, were not always pouched and some were pouched but undated.

The practice had ineffective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. A risk assessment had been completed in line with current guidance, but the recommended actions and control measures were not actioned. For example, there were no logs of temperature checks of the water available for review.

The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste, but these were not always being followed. For example, there were no clinical waste bags in the bins in the decontamination room or toilet, mops were visibly dirty and stored with the heads touching and cleaning schedules were not completed.

The equipment in use was not always maintained or serviced as per manufacturers’ instructions.

The practice completed infection prevention and control audits, but these were not reflective of practice or in line with current guidance. For example, audits were planned to be carried out annually and not 6 monthly.

We saw, and staff confirmed, that single use items were not reprocessed.

The judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.